Sean Mackey, MD, PhD, a Stanford professor and expert in pain management, got a last-minute request to fly to Washington D.C. late last week to testify before a hearing of the U.S. Senate Special Committee on Aging on how to navigate the need for opioids by seniors.
I caught a few minutes of the live stream of his expert testimony, during which he cut quickly to the key issue for physicians: How do you treat pain, which is a particularly important issue for seniors, while at the same time prevent misuse and abuse of these powerful drugs?
"I just did a 13-hour clinic right before coming out here," Mackey said. One of his patients — a 73-year-old woman who suffers nerve pain and needs to takes one opioid in morning and one at night to sleep — told him right before he left: "Please don’t let them take away the medication that’s helping me to function without giving me something else."
"We need to make sure we are addressing both sides of this issue," Mackey told the committee members.
The headlines are frightening: In the last 13 years, there has been a fourfold increase in heroin overdoses in the U.S. fueled primarily by the huge number of prescriptions for opioid painkillers, according to Stanford addiction expert Keith Humphreys, PhD. Each day, 44 people in the United States die from overdose of prescription drugs, in large part due to opioids, according to the U.S. Centers for Disease Control and Prevention.
Concerned about how the epidemic has affected his home state, Senator Bob Casey (D-PA) asked Mackey what could be done to provide pain relief to patients without these unintended consequences: "We want to make sure we are taking the right steps, but we don’t want to take away the opportunity to get pain relief. Tell me about the pain management field. Is there a way to do this, without leading to some of the headlines we are seeing?"
"I can tell you there are a lot of medications and research in the pipeline," Mackey responded. "Translating it into safer and effective treatments is the challenge we have as physicians and researchers."
Mackey detailed the National Pain Strategy, which he co-chaired and which set 17 goals toward achieving better pain relief for patients with improved treatment, better coordination of care, and research that could lead to new and improved medications.
"If we can all get behind these 17 goals, it would make a huge dent in this epidemic because the right patient would get the right treatment," Mackey said.
Previously: Study: Effects of chronic pain on relationships can lead to emotional distress, National survey reveals extent of Americans living with pain, Chronic pain: Getting your head around it, Relieving pain in America and Stanford’s Sean Mackey discusses recent advances in pain research and treatment
Photo by Bill Lenner